5-Aminolaevulinic acid-based photodynamic therapy in the treatment of recalcitrant vulvar sclerosing moss: a case report

Vulvar lichen sclerosus (VLS) is a chronic inflammatory skin disorder that predominantly affects prepubertal girls and postmenopausal women. The main clinical manifestations are severe vulvar itching, burning pain and dyspareunia. Corticosteroid ointment is the first-line treatment for VLS. However, long-term use may lead to skin atrophy and telangiectasia. Surgical treatment has major limitations due to trauma, long postoperative recovery, disruption of normal vulvar anatomy and impact on quality of life. 5-Aminolaevulinic acid-based photodynamic therapy (ALA-PDT) is a safe and effective treatment. Here we report the case of a 59-year-old postmenopausal woman with VLS who had recurrent vulvar ulcers for more than 10 years, with dysuria for 2 years. The patient had undergone labial adhesion release surgery one year ago, but the adhesion recurred after surgery. After admission this time, surgical treatment combined with photodynamic therapy was performed and the curative effect was remarkable.